Autonomic nervous system dysfunction and serum levels of neurotoxic and neurotrophic cytokines in patients with cobalamin deficiency

作者：Ceneli Ozcan^*; Aki Sahika Zeynep; Kucuk Betul Cevik; Tokcaer Ayse Bora; Kuruoglu Reha; Yagci Munci

来源：Turkish Journal of Hematology, 2010, 27(4): 250-256.

DOI：10.5152/tjh.2010.46

• Cobalamin deficiency
• autonomic dysfunction
• dysautonomia
• autonomic neuropathy
• serum cytokine levels

Objective: The imbalance between neurotoxic cytokine tumor necrosis factor-alpha (TNF-alpha) and neurotrophic cytokines epidermal growth factor (EGF) and interleukin-6 (IL-6) plays a role in the pathogenesis of cobalamin (Cbl) deficiency-induced neuropathy. The aim of this study was to evaluate autonomic nervous system dysfunction and to look for any relationship between autonomic nervous system disturbances and serum cytokine levels (TNF-alpha, EGF, IL-6) in patients with Cbl deficiency.
Materials and Methods: Serum levels of TNF-alpha, EGF and IL-6 were studied in patients with Cbl deficiency (n=41) and a healthy control group (n=17) and after 3 months in patients who underwent Cbl replacement therapy (n=22). All patients with Cbl deficiency underwent electrophysiological studies (EPS) for the diagnosis of neuropathy. Statistical analysis was performed using SPSS for Windows 11.5 software.
Results: With EPS, 29 of 41 Cbl-deficient patients (70.73%) demonstrated neurological dysfunction [3 (7.32%), 19 (46.34%) and 7 (17.07%) patients with sensorimotor peripheral neuropathy, parasympathetic, and sympathetic autonomic dysfunction, respectively]. Although there was no significant difference in serum levels of EGF and IL-6 between patients with versus without autonomic dysfunction, levels were significantly lower in Cbl- deficient patients than healthy controls.
Conclusion: Presence of autonomic dysfunction seems to be a frequent neurological finding in patients with Cbl deficiency. However, we could not find any relationship between serum cytokine levels and autonomic dysfunction by EPS. (Turk J Hematol 2010; 27: 250-6)

• 出版日期2010-12